Cardiomyopathy & Carditis

Question 0

inappropriate myocardial hypertrophy in the absence of HTN or aortic stenosis

Answer 0

hypertrophic CM

Question 1

ventricular enlargement & systolic dysfunction

Answer 1

dilated CM

Question 2

reduced filling & reduced diastolic fxn

Answer 2

restrictive CM

Question 3

dilated CM diagnostic criteria (2)

Answer 3

EF < 45% or fractional shortening 117% (larger volume due to widening)

Question 4

pulmonary congestion, systemic congestion, low cardiac output, tachycardia, tachypnea, JVD, S3 gallop, rales, hepatomegaly

Answer 4

dilated CM

Question 5

dilated CM tx

Answer 5

activity/fluid/salt restrictions
ACE inhibitors
diuretics
DIgoxin, B-blockers, antiarrhythmics

Question 6

dyspnea, syncope, angina, palpitations

Answer 6

hypertrophic cardiomyopathy

Question 7

murmur that increases when pt stands or Valsalvas

disappears if pt squats

Answer 7

hypertrophic CM

Question 8

hypertrophic CM tx (4)

Answer 8

activity restriction!
B-blockers, diuretics
Ca2+ blocker: Veraprimil
Amioderone (anti-arrhythmic)

Question 9

rigid ventricular wall with impaired diastolic ventricular filling

Answer 9

restrictive CM

Question 10

etiologies of restrictive CM (3)

Answer 10

amyloidosis, sarcoidosis, hemochromatosis

Question 11

left HF sxs (3)

Answer 11

pulmonary congestion
dyspnea
orthopnea

Question 12

right HF sxs (4)

Answer 12

edema
nausea
abd pain
nocturia

Question 13

RHF & LHF sxs, prominent JVP, abnormal mitral inflow pattern

Answer 13

restrictive CM

Question 14

fatigue, chest pain, heart failure, cardiogenic shock, arrhythmia, sudden death, “flu like”

Answer 14

myocarditis

Question 15

labs for myocarditis (3)

Answer 15

elevated BNP & trop
Echo: LV dilation, abn wall motion, decreased systolic fxn
nasal swab for virus

Question 16

native valve IE

Answer 16

due to mouth organisms (streptococci, enterococci, & staphylococci)
Mitral & aortic valves

Question 17

prosthetic valve organisms

Answer 17

Staph, G-, fungi

Question 18

IV drug IE presentation?

Answer 18

right sided- tricuspid, pulmonic

staph aureus usually

Question 19

fever, murmur, chills/sweats, anorexia, splenomegaly, arthralgias

Answer 19

Infective Endocarditis

Question 20

IE physical exam findings (5)

Answer 20

Osler's nodes
clubbing
Roth's spots
Janeway lesions
petechiae

Question 21

IE tx

Answer 21

4-6 weeks IV abx

Question 22

sharp, severe chest pain aggravated by breathing & position change & laying down, alleviated by sitting up & leaning forward

Answer 22

Pericarditis

Question 23

sound of pericarditis

Answer 23

pericardial friction rub

Question 24

pericarditis imaging finding

Answer 24

EKG: widespread elevation of ST segments

Question 25

constrictive pericarditis results?

Answer 25

decreased stroke volume, cardiac output —> tachypnea

Question 26

fluid overload, DOE, increased JVP, pericardial knock, pulsus paradoxus, Kussmaul’s sign

Answer 26

constrictive pericarditis

Question 27

constrictive pericarditis imaging findings

Answer 27

CXR: calcifications
Echo: thickness of pericardium

Question 28

pericardial effusion physical exam findings?

Answer 28

friction rub has disappeared, heart sounds become faint

Question 29

pericardial effusion imaging findings?

Answer 29

EKG: low voltage of QRS

Echo is best

Question 30

3 causes of pericardial tamponade?

Answer 30

neoplasia
idiopathic
uremia- renal failure

Question 31

alternating size of QRS complex

Answer 31

electrical alternans

Question 32

Beck’s Triad

Answer 32

distended neck veins: elevated JVD
distant/muffled heart sounds
hypotension

Question 33

tachycardia, tachypnea, anxiety, signs of low CO, pulsus paradoxus, electrical alternans, decreased voltage

Answer 33

pericardial tamponade

Question 34

pulsus paradoxus

Answer 34

> 10 mmHg difference b/w inspiration & expiration

Inspiration temporarily decreases LV output